NPI age
12 years
Enumerated 2013-12-10
● Active Type 2 · Organization
Carmine Petracca
Carmine Petracca is 1 of 55 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Petracca
Owner
Last NPPES update
2013-12-10
Source: monthly bulk 2026-05
How this organization compares
Across 55 active clinic/center providers in Idaho.
NPI age
12 years
↑ 3 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2013 → 2026
2013-12Enumerated in NPPES
2013
2026
Where they practice
Primary practice location
939 Bryden Ave
Lewiston, ID 835015057
Mailing address
939 Bryden Ave
Lewiston, ID 835015057
Authorized official
Carmine Petracca, O.D.
Owner
📞 2087431761
Individual providers at this organization
3 individual providers on file at this primary practice address.
- James Pierce, DDS Dentist NPI 1013910371
- Jason Ritter Optometrist NPI 1588071633
- Randy Sorensen, D.M.D. Dentist NPI 1124037924
Specialties
-
Clinic/Center PrimaryDefinition to come...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Bryden Family Vision
Practice context
Multi-provider organization. 3 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.